HCPCS C9607 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Outpatient PPS • Percutaneous Transcatheter/Transluminal Coronary Procedures |
| Complexity Level | High |
National average reimbursement for HCPCS C9607 by major payers:
$10,203.43
$1,928.79
$1,492.29
$1,048.76
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for HCPCS C9607 | ||||||
United | C9607 | $14736.00 | 1225050396 - NORTHSIDE HOSPITAL, INC., NORTHSIDE HOSPITAL CHEROKEE | 581954432 - (GA) NORTHSIDE HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | C9607 | $7511.00 | 1811001548 - AMBULATORY SURGERY CENTER OF OPELOUSAS | 721502278 - (LA) AMBULATORY SURGERY CENTER OF O | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9607 | $6470.00 | 1073026639 - MID CITY SPECIALTY CENTER, LLC | 822996794 - (LA) MID CITY SPECIALTY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9607 | $23830.00 | 1295723229 - ST FRANCIS MEDICAL CENTER, INC | 720408970 - (LA) ST FRANCIS MEDICAL CENTER INC | LA | General Acute Care Hospital (282N00000X) |
United | C9607 | $9324.00 | 1104181247 - ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA LLC | 455502071 - (LA) ADVANCED SURGERY CENTER OF NORTHERN LOUISIANA, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9607 | $8917.00 | 1053453134 - ADVANCED SURGICAL CONCEPTS LLC | 331035210 - (LA) ADVANCED SURGICAL CONCEPTS LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9607 | $20137.84 | 1568663920 - PROGRESSIVE ACUTE CARE AVOYELLES, LLC, AVOYELLES HOSPITAL | 813465468 | LA | General Acute Care Hospital (282N00000X) |
United | C9607 | $14976.00 | 1780690180 - HOSPITAL SERVICE DISTRICT NO. 1 OF IBERIA PARISH, IBERIA MEDICAL CENTER | 726014963 | LA | General Acute Care Hospital (282N00000X) |
United | C9607 | $4156.00 | 1144216847 - RIVER PARK ASC LLC | 721510504 - (LA) RIVER PARK ASC LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9607 | $1196.00 | 1417957796 - ENDOSCOPY CENTER OF MONROE | 721130603 - (LA) ENDOSCOPY CENTER OF MONROE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9607 | $4872.00 | 1821279720 - NEW ORLEANS LA UPTOWN WEST BANK ENDOSCOPY ASC LLC, MGA GASTROINTESTINAL DIAGNOSTIC AND THERAPEUTIC CENTER | 205904604 | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9607 | $41032.00 | 1063735702 - , OCHSNER OUTPATIENT SURGERY SUITE | 720502505 - (LA) OCHSNER CLINIC FOUNDATION | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9607 | $8917.00 | 1437419660 - ADVANCED SURGERY CENTER OF METAIRIE LLC | 453386956 - (LA) ADVANCED SURGERY CENTER OF METAIRIE | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9607 | $6470.00 | 1073026639 - MID CITY SPECIALTY CENTER, LLC | 822996794 - (LA) MID CITY SPECIALTY CENTER LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | C9607 | $3242.00 | 1477698454 - REGIONAL EYE SURGERY CENTER,LLC | 721484653 - (LA) REGIONAL EYE SURGERY CENTER, LLC | LA | Ambulatory Surgical Clinic/Center (261QA1903X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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HCPCS C9607 vs. Other Percutaneous Transcatheter/Transluminal Coronary Procedures Codes
The HCPCS C9607 code is part of the Outpatient PPS services used for Percutaneous Transcatheter/Transluminal Coronary Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The HCPCS C9607 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| C9606-HCPCS | High | Percutaneous transluminal revascularization of acute total/subtotal occlusion during acute myocardial infarction, coronary artery or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty, including aspiration thrombectomy when performed, single vessel |
| C9607-HCPCS | High | Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; single vessel |
| C9608-HCPCS | High | Percutaneous transluminal revascularization of chronic total occlusion, coronary artery, coronary artery branch, or coronary artery bypass graft, any combination of drug-eluting intracoronary stent, atherectomy and angioplasty; each additional coronary artery, coronary artery branch, or bypass graft (list separately in addition to code for primary procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including HCPCS C9607. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the C9607 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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